Risk factors for corneal ulcers: a population-based matched case-control study in Nepal

Area of Science:

• Ophthalmology
• Public Health
• Epidemiology

Background:

• Corneal ulceration poses a significant public health challenge, particularly in rural and peri-urban regions of Nepal.
• Understanding the specific risk factors is crucial for developing targeted prevention strategies.

Purpose of the Study:

• To investigate the risk factors associated with the development of corneal ulcers in a rural and peri-urban population in Nepal.
• To identify key determinants that can inform public health interventions.

Main Methods:

• A population-based, matched case-control study was conducted within a cluster randomized trial.
• Incident corneal opacity cases were matched to controls based on time, age, sex, and location.
• Conditional logistic regression was employed to analyze risk factors, accounting for the matched design.

Main Results:

• Lower odds of education (aOR 0.60) and non-manual labor occupations (aOR 0.64) were associated with reduced risk.
• Higher odds of protective goggle use (aOR 3.8) and experiencing ocular injury (aOR 7.7) were significantly linked to increased risk.
• Preference for medical shops over eye care system centers for trauma care was also a risk factor (aOR 0.58).

Conclusions:

• Ocular injury, manual labor, and lower educational attainment are strongly associated with corneal ulcer development.
• Interventions should aim to increase access to eye care services in areas where these risk factors are common to mitigate the burden of corneal blindness.